These instructors and many others around the country employed a method known as visual thinking strategies (VTS) that linked visual art concepts with physical diagnosis. VTS is a method that was developed by Abigail Housen, DEd, a cognitive psychologist, and Philip Yenawine, an art educator. Originally, this technique was created as a tool to foster aesthetic development and to assist empathic understanding of others’ experience of the visual world through visual art. VTS has gained popularity as a way of using art to assist students in developing critical thinking, communication, and observation skills.
An interesting article about VTS published in Smithsonian magazine describes how the process has been used to improve the visual skills of police detectives so that they can increase their observations at crime scenes.3 In fact, these skills were credited in helping members of an undercover task force assigned to break up the mob control of garbage collection in Connecticut. According to Bill Reiner, the FBI special agent who headed the task force, these visual exercises helped one key undercover agent sharpen his observations of office layouts, storage lockers, desks, and file cabinets containing incriminating evidence. Reiner praises the effectiveness of VTS: “Don’t just look at the picture and see a picture. See what’s happening.” The information that this particular agent provided led to detailed search warrants and ultimately resulted in 34 convictions and government seizure and sale of 26 trash-hauling companies worth $60 million to $100 million. Here are your taxpayer dollars hard at work!
How can we apply VTS to our everyday practice of medicine? First, clinicians need to adopt a bit of the art critic’s mindset. We should learn how to read and interpret patients’ gestures and expressions. Was there eye contact when speaking with the patient? Was her smile crooked, or that eye a bit droopy, telltale signs of a facial palsy? (See Bell’s palsy: The answer to the riddle of Leonardo da Vinci’s Mona Lisa.5) First impressions may not always hold true; a second look might have you seeing things differently (See Rene Magritte, The Voice of Space4). Don’t get caught just looking at the obvious, to where the eye is initially drawn. As VTS teaches, try to see what is going on “in the shadows.” (See The Railroad Bridge at Argenteuil by Claude Monet.) Learn to sort out the relevant from the less-significant observations. (See Vase of Flowers with Pocket Watch, by Willem van Aelst.) Some of the imagery of medicine can be grotesque; the initial reflex of the viewer might be to look away. A careful observation of some of the finer details of the image may stimulate a more thoughtful response. (See The Ugly Duchess by Quentin Massys.)
